Latest / Age Like a Badass Mother / Ep. 72: Heal Your Gut, Calm Your Anxiety - Nisha Chellam, M.D.

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Ep. 72: Heal Your Gut, Calm Your Anxiety - Nisha Chellam, M.D. · Age Like a Badass Mother

• 0:00
  Hi friends, my guest this week is Dr.
• 0:02
  Nisha Chilam.
• 0:04
  She knows that gut health and anxiety are interrelated and explains how.
• 0:10
  She eats a whole food plant-based diet, but she does mention meat because she believes in meeting people where they are.
• 0:16
  So I just wanted you to know that.
• 0:19
  So I'm trying something new.
• 0:21
  I want to start each podcast by just talking a little bit about eating a whole food plant-based diet.
• 0:27
  Today, I'm just going to talk briefly about the basics and getting started.
• 0:31
  But please send me your questions at lauren at agelikeabadassmother.com and maybe I'll answer yours next week.
• 0:39
  Please don't forget to like and subscribe to the podcast.
• 0:43
  I greatly appreciate it.
• 0:44
  And please see the show notes for any information about my free cookbook and my online class.
• 0:51
  Here we go.
• 0:54
  Hi friend, are you looking to age healthfully, confidently, and vibrantly?
• 0:58
  Then this podcast is for you.
• 1:00
  Smart, slightly salty, irreverent, and thought-provoking.
• 1:04
  I'm Lauren Burnick and this is Age Like a Badass Mother.
• 1:12
  Hi friends.
• 1:13
  Okay, I wanna start something new.
• 1:15
  I just wanna talk a little bit about eating a whole food plant-based diet at the beginning of each podcast.
• 1:22
  This week, I just wanna talk about the basics, just how you get started because I know it can be really difficult.
• 1:28
  And so I just wanna break it down and make it super easy.
• 1:31
  So what I would do is start by eating the same breakfast every day.
• 1:36
  You don't have to overthink it.
• 1:37
  Just make some oatmeal.
• 1:39
  know, sometimes I even just eat my oats raw.
• 1:42
  just some oats with some plant milk, with some berries.
• 1:47
  If you wanna get fancy, you could put a little ground flax meal in it.
• 1:52
  uh And that's it, just don't make it crazy.
• 1:56
  You do want to make sure that your plant milk does not have oil in it.
• 2:01
  uh I just have been using uh the soy milk from Whole Foods and...
• 2:09
  There's tons of brands out there, but generally the refrigerated ones and usually like the Oatly have oil in them.
• 2:17
  So just be really careful about that.
• 2:19
  For lunch, again, just make it simple.
• 2:22
  You can make a sandwich.
• 2:24
  um You can use Ezekiel bread.
• 2:27
  You could use Dave's Killer bread in the green packaging.
• 2:30
  I know that one doesn't have oil.
• 2:33
  You can find an oil-free hummus.
• 2:36
  and just smear that on there and then just load up on the veggies, know, spinach and um tomatoes, and you could use like banana peppers or some pickled jalapenos.
• 2:47
  You can use lettuce and tomato and pickles.
• 2:51
  Just put that on your sandwich.
• 2:53
  Just stack it really high.
• 2:55
  You can even do an open face sandwich.
• 2:57
  I know Anne Esselstyn swears by those.
• 3:01
  So you're only using one piece of bread.
• 3:03
  The bread part doesn't really bother me.
• 3:05
  um You can do a salad on the side or you could just do a big salad with some beans in it.
• 3:10
  Find a good oil-free salad dressing that you like.
• 3:14
  Just Google plant-based oil-free salad dressings.
• 3:18
  There's a million out there.
• 3:19
  There's some in my uh cookbook that you can get at wellelephant.com.
• 3:24
  It doesn't have to be mine.
• 3:25
  It just has to be one that you like.
• 3:27
  And then for dinner, again, simple.
• 3:31
  You know, you're already eating foods that are whole food plant-based.
• 3:36
  that can just give them a little tweak.
• 3:40
  Instead of spaghetti, like white spaghetti, you can use whole wheat spaghetti, or you could use, they have all these great pastas now that are like chickpea or brown rice or lentil.
• 3:52
  Just use a pasta, make sure it's vegan, make sure it doesn't have oil.
• 3:55
  You have to get used to reading the ingredients.
• 3:58
  You can, again, get a fat-free marinara at Whole Foods that doesn't have oil.
• 4:03
  um So there, and then just add vegetables again, just like throw in a bunch of mushrooms, throw in a bunch of kale, broccoli.
• 4:14
  You're always trying to add vegetables, bulk things up with vegetables.
• 4:19
  That's the main thing.
• 4:20
  You can make tacos for dinner.
• 4:22
  um You can just use a can of fat-free refried beans.
• 4:27
  Make sure it doesn't have oil in it.
• 4:29
  I know I sound like a broken record, but just make sure it's vegan.
• 4:32
  Make sure it doesn't have lard in it or chicken stock.
• 4:34
  Make sure it doesn't have oil.
• 4:36
  So you can get a can of fat-free refried beans, smear it on a organic corn tortilla or a whole wheat tortilla.
• 4:45
  uh And again, load it up with vegetables.
• 4:48
  You could put zucchini, you could put mushrooms.
• 4:51
  I love to buy the bagged coleslaw mix.
• 4:54
  That's just all it is is shredded cabbage.
• 4:57
  and just throw that in there.
• 4:59
  You can throw in some tomatoes, you can throw in some pickled jalapenos, some salsa, and that's an idea.
• 5:06
  So you don't have to get crazy.
• 5:08
  um Just make a bowl with brown rice and beans and some steamed vegetables.
• 5:15
  That's an idea.
• 5:17
  Don't make it too hard on yourself.
• 5:19
  And that's how you get started eating a whole food plant-based diet.
• 5:24
  Send me your questions if you have any.
• 5:26
  Lauren, at AgelikeABadassMother.com.
• 5:30
  And now here's Dr.
• 5:32
  Chelham.
• 5:34
  Dr.
• 5:35
  Chelham is a board certified MD who calls herself a recovering physician, having chosen to move away from medications as the only option for sick patients.
• 5:45
  Using the principles of functional medicine, she helps her patients understand how their bodies work to optimize their health naturally.
• 5:52
  She is the author, a bestselling author of Transform Your Thyroid, the five steps to regain your thyroid and get back your life.
• 6:02
  Please welcome Dr.
• 6:03
  Nisha Chilam.
• 6:05
  Welcome.
• 6:07
  So glad to have you.
• 6:08
  Appreciate it.
• 6:09
  um Well, I guess let's just start with a really basic question.
• 6:14
  Can you just explain the difference between functional medicine and traditional medicine?
• 6:21
  Conventional.
• 6:22
  We call it conventional.
• 6:23
  Traditional people would think it's Chinese or Indian.
• 6:27
  Yeah.
• 6:27
  So when you look at conventional medicine, the focus of training, the focus of the thought process is what do you have and how do we get you better?
• 6:39
  That's how in conventional, whenever you go to the doctor, you have a particular complaint, they're trying to get to a diagnosis and then connecting it to a drug or to a treatment plan.
• 6:49
  In functional medicine, we look at the same issue and instead of asking, what do you have?
• 6:55
  We ask, why do you have it and why now?
• 6:59
  So it's just a different way of thinking.
• 7:01
  People think when they come to a functional medical doctor, it's something holistic and they're going to give me herbs to get better.
• 7:10
  we do use herbs.
• 7:11
  We do use a lot of alternative treatment plans, but that is not the foundation of functional medicine, it's more of understanding why you have something and why now and why wasn't it yesterday and what is this going to become tomorrow and what can we do to resolve it.
• 7:32
  So it's a completely uh different way of thinking rather than a different way of medicine.
• 7:39
  Yeah, you're just trying to get to the root of the problem.
• 7:42
  I love that.
• 7:43
  That's uh okay.
• 7:44
  You're speaking my language um Let me let me just start with I guess what Brought you to this was it was it your thyroid that kind of turned your head around to functional medicine no, not at all.
• 7:59
  didn't even know I was sick.
• 8:01
  So in fact, I had accepted my health the way it was with allergies for almost 30, 25 years with migraine headaches because I thought it was genetic.
• 8:13
  I was a pre-diabetic because I thought it was genetics because nine of my aunts and uncles were diabetic.
• 8:18
  What really shifted me was a certain sense of frustration.
• 8:24
  You show up at work and every day you fail at your job.
• 8:27
  but you get paid for failing.
• 8:29
  That's really the practice of medicine, right?
• 8:33
  People come to you with a problem.
• 8:34
  You are treating them for the problem with the knowledge that you've gathered through your training.
• 8:41
  And you get them better for the moment, but they're never better.
• 8:44
  It's like if somebody has osteoarthritis, osteoarthritis is an aging disease and you're gonna be having that for the rest of your life.
• 8:52
  Diabetes, once a diabetic, always a diabetic, you're gonna have it rest of your life.
• 8:58
  And having that thought process created for me a clinic filled with patients who were constantly sick, never got better, constantly complained, wanted me to fix their problems.
• 9:13
  And the only tool in my toolbox were more medications, different medications, referrals, nothing else.
• 9:21
  I had nothing else to offer my patients.
• 9:23
  If they said, there something I could eat that would get better, my neighbor drank cherry juice.
• 9:29
  Should I be doing that?
• 9:30
  I had no clue.
• 9:32
  Right.
• 9:34
  So one of my patients actually got better.
• 9:36
  uh He refused all kinds of treatments.
• 9:40
  He was in his young, the 50s, probably just turned 50.
• 9:46
  And he showed an improvement in his bone density in two years with no medication.
• 9:53
  And I had never heard of anybody getting better with osteoporosis or osteopenia.
• 9:59
  My mind was blown because I said, okay, if a patient like this could, as I sat down and I spoke to him, he showed me a big list of supplements.
• 10:08
  He showed me that he went to a chiropractor.
• 10:10
  He went to a integrative doctor.
• 10:12
  And I'm like, what are all these people?
• 10:14
  I had no clue.
• 10:16
  All I was taught when I was in medical school is chiropractors, break your neck, don't go to them.
• 10:20
  And I'm like, okay.
• 10:22
  Here's a guy who's telling me a completely different story.
• 10:24
  And I started going down the street to meet the chiropractor.
• 10:28
  I learned a lot about that.
• 10:30
  I learned a lot about integrative medicine.
• 10:32
  But eventually the one that really caught my attention was functional medicine.
• 10:36
  Because for the first time, I was able to see blood tests that showed what my patient was complaining of.
• 10:44
  An example would be somebody would say, I'm fatigued and fatigued.
• 10:48
  And all of their regular blood tests would come back completely normal.
• 10:51
  And I'm like, my God, this person is just driving me nuts.
• 10:54
  She keeps saying she's fatigued.
• 10:55
  I don't know what to do for her.
• 10:56
  But a functional medical lab will show me inflammation, will show me antibodies, will show me where this person was having a problem and how I could address their fatigue.
• 11:09
  It's just a deep dive into a person's physiology, interpreting their labs in the way you should.
• 11:18
  to understand what the patient is saying.
• 11:20
  And I will say, after I've done functional medicine, I've never met an anxious woman.
• 11:27
  I've never met, I mean, like when people come to me with crazy problems, they're not crazy, there is a problem, they just don't know how to express it.
• 11:35
  That's what functional medicine has taught me.
• 11:37
  So yes, a patient taught me a different approach, but when I discovered functional medicine, that's what I wanted to do, though I was trained in integrative, I went into functional medicine more.
• 11:48
  because of the deep dive testing.
• 11:51
  And then when I did my own blood test, that's how I discovered, oh my God, I am like a mess.
• 11:58
  And that's when I started working.
• 12:01
  So I was my own first patient.
• 12:03
  I started working on my gut health, my nutrition, my sleep, exercise.
• 12:09
  And the migraines that I had from the age of 11 completely disappeared.
• 12:13
  It's been 17 years since I've had a migraine, whereas the rest of my family still struggles with it.
• 12:18
  I'm no longer a diabetic.
• 12:19
  know I'll never be a diabetic.
• 12:22
  I don't have allergies or eczema anymore, which literally most, used to walk around with Flonase, Zertag, Claritin.
• 12:30
  I don't even have to touch any of those.
• 12:33
  Wow.
• 12:34
  You're just a walking success story.
• 12:37
  And how did you reverse all of those things?
• 12:40
  I mean, I know that's a really big question, but can you just give me like the short thing?
• 12:46
  version of it, will say what you learn in functional medicine is there is a genetic component to everything, right?
• 12:54
  But these genes are not your, like they say, DNA is not your destiny.
• 13:00
  You can actually turn on certain genes and turn off certain genes.
• 13:05
  But in order to do that, you have to make sure you have the right nutrients or right uh trigger that will turn off a gene or turn on a gene.
• 13:16
  And most of these triggers are biochemical, that means your food, how you shift your food, how your gut is designed, like does it process the food, does it extract the nutrients, do you have a solid immune system?
• 13:33
  If you ask me of all the systems in your body, if you have a rock solid immune system, you're going to be healthy.
• 13:41
  If your immune system gets disrupted, Your body will miss cancer.
• 13:46
  Your body will get you more sick more often or your body will get sick more often because your immune system is not robust and you'll have a lot of chronic diseases.
• 13:58
  But where was the immune system housed?
• 14:00
  Most of it is housed in the gut.
• 14:02
  So if your gut is healthy, the neighborhood is healthy, which is your immune system and you are healthy.
• 14:09
  So a lot of my approach was understanding my gut health, understanding my genetics, and shifting my diet, my lifestyle around that.
• 14:20
  For instance, I come from India, which is, I know it's obvious, but sometimes you have to say that.
• 14:26
  I don't know if you've ever known an Indian, especially from south of India, we don't finish a meal without yogurt rice.
• 14:34
  Like that's our period.
• 14:35
  You finish the meal, you've got to have a little bit of yogurt rice.
• 14:38
  So milk and dairy products, was something that I never would have thought I could ever give up in my life.
• 14:47
  I would add a lot of cheese to everything.
• 14:50
  And even if I have a Taco Bell was my closest, like that's where I would go and I would get the seven layer bean burrito with extra cheese in it.
• 14:57
  That was my life, right?
• 15:00
  And when I realized genetically, I don't process milk, I'm prone to inflammation.
• 15:05
  have a problem with methylation, a huge series of things.
• 15:09
  It took me maybe a couple of months, but I completely gave up milk and it transformed my life.
• 15:16
  Completely transformed my life.
• 15:18
  So sometimes it's good to know what your body needs and how to support it.
• 15:23
  So if you abuse your body without your knowledge, which is what most of us do, we do a lot of things because it's healthy.
• 15:29
  Nobody ever said milk is unhealthy.
• 15:31
  Nobody's ever said that growing up.
• 15:34
  Milk was yogurt is...
• 15:36
  What do they call probiotics?
• 15:37
  You should have yogurt, should have buttermilk.
• 15:40
  So we're always raised, it wasn't an unhealthy food item, but if your body cannot process it and you don't know and you're taking a nasal spray, you're taking pain medicines, you're dealing with the skin rash, steroid cream, and you're getting migraine headaches and just removing that one food item can literally heal you.
• 16:03
  It's worth a try.
• 16:05
  Yeah.
• 16:05
  And so that would be a place to start if you're having all those symptoms is to remove dairy.
• 16:11
  Well, I wouldn't say for everybody, but there are certain items like asthma, skin conditions, acne.
• 16:19
  Dairy seems to be a huge role.
• 16:21
  There's a lot of studies that show dairy plays a big role.
• 16:24
  I don't know if it's how they process the dairy, but I will say it's not even how they process the dairy.
• 16:29
  I think it is the dairy because I was raised in India for the first 25 years of my life.
• 16:33
  And that was quite unprocessed.
• 16:35
  I remember the milkman coming home and delivering milk.
• 16:39
  Like he would milk the cow right in front of us because they were very sure you should not add water to it.
• 16:45
  So it was straight up milk and these cows were grazing wild.
• 16:52
  So it wasn't like they were industrialized animals.
• 16:55
  So I think it's the milk some of us cannot tolerate.
• 16:58
  Almost it's the study shows 65 % cannot tolerate it.
• 17:03
  So it's best tested.
• 17:05
  Yeah, it's a lot.
• 17:06
  tested.
• 17:06
  Get tested.
• 17:07
  But also, I'm sorry, like I don't want to shame anybody for eating dairy, but also that dairy is for a cow.
• 17:16
  It's not for a human if you think about it, right?
• 17:18
  I mean, it's for a mama cow, for a baby cow.
• 17:21
  Yeah.
• 17:22
  Like if they were delivering breast milk to your house, that might be a different story.
• 17:27
  It might be something that you could process better, I think.
• 17:30
  I know, I mean, I will say there have been studies that show when children drink cow's milk, they tend to grow taller, maybe because of the excess protein that's there, almost 10 times more protein than what human breast milk has.
• 17:46
  However, I will say the ecosystem we live in, when you look at human beings, we were supposed to thrive with everything that we have accessible to us.
• 17:58
  So I will say there's a group of people in India who will not eat anything grown under the soil.
• 18:04
  And they will wear a mask, they don't like to harm other creatures, but they will drink the cow's milk.
• 18:13
  That's an extract, the cow is like God to some sex of the people, religious groups.
• 18:22
  I don't know if it is, I mean, yeah, there's a choice.
• 18:25
  Like would you drink a dog's milk?
• 18:27
  Why do you choose a cow's milk over a dog's milk?
• 18:29
  And I think to a large degree that rational is there, but there are some benefits to milk, but more than anything else, if you're struggling with chronic illnesses, is one of the known proteins that you have to remove.
• 18:44
  And it's not the lactose, it's actually the casein in it that triggers off your immune system.
• 18:49
  Yeah.
• 18:50
  Okay.
• 18:50
  Well, let's talk about aging and um what are some of the things that we're getting wrong about aging and also what are the earliest signs that aging is going off the rails, like some symptoms and things to look out for?
• 19:10
  So aging, think what we're getting wrong about is people scream about their biological age.
• 19:17
  They'll say, I'm 50, but my biological age is 29.
• 19:22
  I'm not really sure what that means because I don't think you will have a 60 year old who has been taking very good care of themselves and you're going to mistake them for a 20 year old.
• 19:32
  I don't think that ever happens unless they have extraordinary genes.
• 19:38
  So I don't think aging is reversing and becoming younger.
• 19:43
  It means you're optimizing the function of your body for the decade of life you're living.
• 19:50
  So if you are 40, you are the best 40 year old you can ever be for the set of genes and the tools that you have.
• 20:00
  What that means, mean, first of all, I have to put this out there.
• 20:05
  There is no disease of aging at 40 and 50.
• 20:09
  When they say my knee hurts, oh I can't remember things, it must be age.
• 20:12
  There's nothing like that.
• 20:14
  That would be the wrong notion.
• 20:17
  I think what aging is, when you have a problem that doesn't seem to go away, like for instance, you have an allergy, it goes away once you remove the allergen, that is a good immune system that you you stop, remove the trigger, you got better.
• 20:39
  But when you move away from the trigger, like people say, in Florida, I get congested, but when I moved to Michigan, I feel fine.
• 20:47
  But when they moved to Michigan, they're still congested and they never get better.
• 20:51
  And they'll say, I just went to Florida for one month and I've never been better.
• 20:55
  That is an aging.
• 20:56
  And aging is every system of your body ages at a different time.
• 21:00
  Your immune system ages differently.
• 21:02
  Your muscular skeletal system ages differently.
• 21:05
  People can look young, have flawless skin, but they might have arthritis.
• 21:13
  every system, cardiovascular system can age.
• 21:15
  Like somebody could have high blood pressure, high cholesterol, have to take a bunch of medicines to just control that.
• 21:21
  Brain health could be different.
• 21:23
  So every system ages differently and to some degree it is genetically determined and to large degrees determined by your environment.
• 21:34
  So aging is not about taking a bunch of supplements and sitting in a sauna.
• 21:39
  is your daily habits.
• 21:42
  What do you do on a daily basis?
• 21:44
  And it's very simple.
• 21:45
  That's why functional medicine doesn't catch fire like conventional medicine.
• 21:50
  It's the advice we give that your grandmother would have given.
• 21:54
  Go to bed on time, sleep, uh try to get some good sleep, eat healthy, eat whole foods.
• 22:03
  move every day, don't stress over things that you cannot change, and hang out with a good community of people who have positive vibes.
• 22:15
  You do all of that, it's almost impossible to false set.
• 22:19
  Wow, I mean that just seems so basic, but I guess we're not doing that.
• 22:24
  None of us are doing that, right?
• 22:25
  Even I, I preach about it.
• 22:27
  I don't do that.
• 22:28
  I find myself going to sleep at 11, 30, 12 and waking up at four because I just feel like I got lots to do.
• 22:35
  So yes, we're all not doing it on a regular basis.
• 22:39
  So when I find people come to me with a slew of illnesses, that's where I stopped.
• 22:44
  Those are what you call the modifiable risk factors.
• 22:48
  Are you able to shift your daily habits to promote health and wellbeing?
• 22:54
  or because you can say I'm stressed and then take an adrenal supplement for supporting your adrenals, it's not gonna matter.
• 23:03
  For a moment, you'll feel better, but ultimately the stress is gonna go over the supplement, right?
• 23:08
  You have stress, you get a supplement, you bring it down a little, but you haven't taken care of what is driving your stress and it's gonna eventually go about the supplement.
• 23:17
  Are you gonna take more supplements or change the supplement?
• 23:19
  Yes, you can do that, but you gotta address what is feeding your stress.
• 23:24
  And a lot of times people don't because how many women do we know or how many men do we know that stay in a marriage for 20 years?
• 23:32
  How many people do we know?
• 23:34
  They say I've invested so much into my career.
• 23:37
  Doctors, for example, I've been a doctor all my life.
• 23:41
  I hate my job, but that's all I know how to do.
• 23:45
  That would be tragic.
• 23:46
  But a lot of people do that.
• 23:48
  And I think we need to keep in mind something is you feel as a trigger is making you sick.
• 23:57
  You're waking up on Monday morning and dreading to go to work.
• 24:02
  That can age you.
• 24:04
  So aging is not something about just taking lotions and potions and sitting in a sauna.
• 24:09
  It's more about what you do in a daily basin.
• 24:13
  How your sympathetic and parasympathetic nervous system are aligned.
• 24:17
  If you're mostly in parasympathetic state, you will not age.
• 24:20
  I promise you that.
• 24:22
  That's why monks and yogis don't age so much.
• 24:25
  Age.
• 24:25
  oh And so you're just saying like, get good sleep, get good nutrition, exercise, try to control your stress.
• 24:35
  mean, those are all things we've talked about a lot on the program, but it's good advice for any of that.
• 24:44
  Yes, yes.
• 24:46
  So let's talk about nutrition.
• 24:48
  The biggest confusion is nutrition, right?
• 24:51
  People come and ask me, like, for instance, is milk bad?
• 24:54
  Is your gluten bad?
• 24:56
  Or here's what I understand of nutrition.
• 25:00
  I don't know if anybody understands it very well because everybody's either removing something or adding too much of something.
• 25:08
  What I know is if you're eating a certain way, and you have a slew of diseases, that way is not working for you.
• 25:18
  That's it.
• 25:19
  Number one.
• 25:19
  Number two, when you take any diet that has worked, whether it be ketogenic, carnivore, vegan, oh Mediterranean, all of them, what do they have in common?
• 25:30
  They remove processed foods.
• 25:33
  Every one of them removes processed foods, and so it works for most people.
• 25:37
  Everybody feels good when you remove processed food.
• 25:41
  Can you stop eating food like products and eat whole foods, whatever your choice is?
• 25:46
  Like somebody who comes from India, if I've never eaten beef all my life and I was being raised to think of the cow as God, you can't possibly change my mind to go eat a steak, right?
• 25:57
  So you have to work with an individual based on their cultural background.
• 26:02
  Now similarly, if somebody comes to me and they've been a meat and potato guy, if I tell them you gotta remove steak and start eating chicken, that's not about to happen.
• 26:10
  So how do I get them to shift their habits so that they can get the health they're seeking?
• 26:18
  Then I need to understand a little more about their habits, their genetics, and their goals.
• 26:24
  So I think nutrition should be personalized.
• 26:27
  And today in 2025, you can actually do a study called Neutrogenomics where based on your genetics, you can see what kind of, how your body processes certain nutrients.
• 26:41
  There's also something called nutritional epigenetics where how food can uh kind of turn on your genes.
• 26:52
  So you, people are trained in these things.
• 26:55
  You can actually find someone who practice a physician who understands this or a practitioner who understands this and who can help you or guide you through your nutritional uh program or planning.
• 27:07
  Do you do telemedicine?
• 27:09
  Yes.
• 27:09
  Can people come to you?
• 27:10
  Okay, so they can.
• 27:13
  testing and actually do this.
• 27:15
  Okay, I'll put your information in the show notes.
• 27:18
  Yes, absolutely.
• 27:19
  Thank you.
• 27:20
  And the second one is movement.
• 27:22
  I can tell you if you cannot change your diet, you can't sleep well.
• 27:25
  If there's one thing you can do for yourself, please move.
• 27:28
  Get into the habit of exercising every day, particularly building muscle mass.
• 27:33
  And I would have thought, this is common sense.
• 27:35
  Everybody knows.
• 27:36
  So this morning I had a patient ah in her 70s and I said, you know, I want you to strength train.
• 27:42
  She said, oh, lift weights.
• 27:44
  my God, I got osteoporosis.
• 27:46
  I'll crumble and fall.
• 27:47
  You see how the thought, mean, logically she's right, but I told her the first treatment of osteoporosis is actually strengthening your bones with lifting weights.
• 27:59
  You can take all the calcium and the medications you want, but you gotta strengthen.
• 28:03
  She said, I didn't know that.
• 28:04
  I had to spend a half hour just explaining to her and giving her data on why weight training is important for your bone health.
• 28:12
  All right?
• 28:13
  So what I would say is, Women in general build your muscles.
• 28:20
  If you do a body composition scan, your muscle mass should be over 63 % of your body weight should be muscle mass.
• 28:30
  wow, that seems like a lot.
• 28:31
  It seems like lot of have to have 75 % of their body weight.
• 28:34
  So if you're a 100 pound woman, 65 % of that weight should come from muscle.
• 28:40
  Whereas what happens is you can be thin, but you may have 30 % of your body weight is fat and only 57 % is muscle.
• 28:49
  That is another aging process.
• 28:52
  Building muscle should be done proactively.
• 28:56
  At least in your early 30s, mid 30s, if you have missed that, do it in your 40s.
• 29:00
  If missed that, do it in your 50s.
• 29:01
  If you missed that, do it in your 60s.
• 29:03
  It's never too late.
• 29:05
  They've done studies where people are over 65 and they do build muscle mass, even if you have never done it before.
• 29:12
  So start strength.
• 29:14
  I hate to use the word strength training.
• 29:16
  I know we say it very often, but it's almost like start building muscle.
• 29:21
  Strength training is one part.
• 29:22
  I mean, can take elastic bands and do this and say, I do strength training.
• 29:25
  No, you gotta build muscle mass.
• 29:28
  You got that.
• 29:29
  That's all I keep hearing is you got to lift heavy.
• 29:32
  I'm sick of hearing that, but I guess that's what you have to do, right?
• 29:35
  You have to.
• 29:36
  don't have to lift heavy.
• 29:37
  So that's another myth also, because I would say, yes, I know, but it's not lift heavy.
• 29:44
  It's build muscle mass, right?
• 29:45
  Because I lift, I actually gain weight in my hips.
• 29:52
  somewhere my cortisol gets tipped off and I start gaining weight in the wrong places.
• 29:56
  Whenever I hire a trainer, I gain weight, like fat weight.
• 30:01
  So it's very interesting.
• 30:02
  So I've learned I have to lift.
• 30:04
  heavy but not that heavy but I have to lift frequently.
• 30:08
  Short spurts.
• 30:09
  So everybody is different.
• 30:11
  Again, work with someone, figure out your rhythm, figure out what works for your body.
• 30:17
  Always look at the results.
• 30:19
  Because I know lifting heavy, if I did like 40 pounds and 50 pounds and was lifting heavy and squatting, I gained weight.
• 30:27
  I've tried this so many different, I've had three different trainers and everybody, eh always if I lift slower.
• 30:33
  could get but my muscle mass builds.
• 30:37
  One of the things you have to lift is lift to fatigue.
• 30:40
  So some people may have an eight pound weight and they can get fatigued with three sets and other person would need 25 pound weight and get fatigued in two sessions.
• 30:50
  uh glad to hear you saying this.
• 30:53
  This makes more sense to me.
• 30:56
  I mean, I think everything you're saying makes more sense to look at the results, you know?
• 31:00
  Yeah.
• 31:00
  Yeah.
• 31:02
  Okay.
• 31:02
  And then sleep.
• 31:04
  Sleep is a tough one, right?
• 31:07
  I will say sleep is so many things contribute to the disruption of sleep.
• 31:14
  For most of us is our day to day life.
• 31:17
  um Many a time, I when I'm talking to patients who struggle with sleep, I ask them, what is the last three hours before bedtime look like?
• 31:29
  And they would be finishing up dinner, getting the kids to bed, getting ready for the next day, finishing up the last emails, watching a little bit of TV.
• 31:40
  Sometimes they have a glass of wine, have a conversation with their significant other.
• 31:46
  What all of this is doing is a lot of activity for a brain that is supposed to shut down.
• 31:50
  So it's almost like watching a horror movie and then trying to get to bed.
• 31:55
  You need to start unwinding ahead of time.
• 31:59
  Really, I mean, the reading for the kids above.
• 32:04
  Close it off with that.
• 32:05
  There's no work after that.
• 32:07
  There's no TV after that.
• 32:09
  Then cooling your body.
• 32:10
  The most important thing is your body temperature has to be cooled down.
• 32:14
  So even having a quick cold shower, having a cool bedroom, 67 degrees, not having the, what is that feather goose feather comforter?
• 32:25
  Down, down comforter.
• 32:28
  Remove those things.
• 32:29
  Be cool when you get into bed, like literally be cool in your head.
• 32:34
  and temperature wise, you will tend to sleep better.
• 32:39
  So the problem is when you have overhead lights right up to 9 p.m., 10 p.m., your brain doesn't know if it's sunset.
• 32:47
  You should dim the lights when there's sunset.
• 32:50
  So say it's at 7.30, 8 o'clock, start dimming the overhead lights, get the two hour, the brain is getting the message, oh, we're winding down.
• 33:00
  Anything that you that you do that triggers off winding up or charging up is going to get you into trouble.
• 33:09
  Then there is this hormonal aspect, which is where um progesterone is your natural antidepressant, anti-anxiety.
• 33:16
  And we see that in perimenopause.
• 33:18
  So that could be age related.
• 33:20
  The third one is the act of drinking alcohol.
• 33:24
  um It does put you to sleep initially.
• 33:26
  You may just, but it wakes you up in the middle of the night.
• 33:28
  There's a lot of hormonal changes.
• 33:30
  It makes you get up and go to pee.
• 33:33
  Sometimes your blood sugar drops really low.
• 33:35
  your adrenaline pumps up and you're woken up and you feel like and taking something for a, you know, have a bite.
• 33:42
  So all those habits that create a trigger can disrupt sleep.
• 33:48
  There are sleep coaches now.
• 33:49
  You can actually get yourself coached to sleep better.
• 33:53
  And if you can, if you think you figured out everything, you know, there's something like, uh Quiet to your mind and go to sleep is a great book.
• 34:02
  It's a 132 page book.
• 34:04
  I give it to a lot of my patients.
• 34:05
  I ask them to read through that and see what are the problems that they might be able to modify.
• 34:10
  And so that's a good resource for people to look into.
• 34:15
  But you got to sleep because when you sleep, you will, if you're talking about anti-aging sleep is your best anti-aging medicine because you detox at that time.
• 34:25
  We didn't know about that, but your body, and your brain detoxes when you go into deep sleep.
• 34:34
  Oh man, that's good and bad news, I guess, for everybody.
• 34:39
  Okay.
• 34:39
  Yes.
• 34:40
  um Did we cover all the things that we talked stress management is the last one and stress management.
• 34:46
  Yeah, stress management.
• 34:48
  This is very unique to every culture in the world, right?
• 34:52
  They are very unique way of approaching.
• 34:55
  So the way I was raised in India is and something that I learn always is learning to let go.
• 35:05
  You know, you, we invest a lot in relationships and jobs and degrees, but sometimes when it doesn't work for us, we don't let go.
• 35:16
  Um, I heard, um, a story about Quentin Tarantino, the filmmaker.
• 35:23
  Yeah.
• 35:24
  Um, so if you ask about, you know, his various movies, Kill Bill, Pulp Fiction, and two others are there.
• 35:32
  They were all great movies.
• 35:34
  Yeah.
• 35:36
  Very first.
• 35:37
  Yes.
• 35:39
  But the very first uh movie he made was My Best Friend's Wedding.
• 35:46
  He made my best friend's wedding?
• 35:47
  oh Best Friend's Birthday or wedding, one of those.
• 35:51
  No, My Best Friend's Birthday.
• 35:53
  It's called My Best Friend's Birthday.
• 35:57
  It's never been released.
• 36:00
  He spent three years working on it.
• 36:04
  At the end of it, after three years, he said no to the film after he edited and put it together.
• 36:10
  He was only in his 20s.
• 36:13
  You can spend a lot of time, but you should know when to walk away.
• 36:17
  The problem with stress and anxiety, most people, they tend to spend so much time about things that they cannot change.
• 36:26
  You cannot change how someone else behaves, but you can change how you react to that someone else.
• 36:33
  Yep, exactly.
• 36:34
  And I think we waste a lot of time re-running those things in our head.
• 36:41
  Most of our stress comes from our thoughts, not from a situation.
• 36:46
  I got, um let's say, uh somebody um accosted me on the street.
• 36:56
  Like I walked down Detroit, because I'm in Michigan, and somebody stole something from me.
• 37:02
  Does that mean I will never walk in Detroit and every time I go to Detroit, I'm going to have something happen?
• 37:07
  Maybe, I don't know.
• 37:08
  But I'm just saying it should not determine your next.
• 37:12
  Like next time you just take different precautions.
• 37:16
  And you know, probably when you're going down that street, you go with a group of people.
• 37:20
  So you just learn a different way to adapt to the situation rather than fearing it and, you know, building it up.
• 37:28
  more than and they're not going down any street because you know once I went down I got attacked I'm never going to go down.
• 37:34
  So it's more a memory we tend to spend too much time on situations that don't exist.
• 37:41
  So we're ruminating.
• 37:43
  Yeah, ruminating a lot.
• 37:44
  So if you can write down your problems and figure out if something is really bothering you, write down your stressor, figure out what is the problem, how can you solve this?
• 37:56
  And first of all, is this a true problem?
• 37:59
  That is the most important thing.
• 38:00
  Is this a real problem?
• 38:02
  Most of the time it's not a real problem.
• 38:03
  It's an imagined problem.
• 38:06
  Whenever I tell my patients, have I given you supplement?
• 38:08
  Oh, I reacted to a supplement I took 10 years ago.
• 38:11
  what if I react to this?
• 38:13
  Do you know what supplement you reacted to?
• 38:15
  I don't know.
• 38:16
  Whenever you're going to know, you're going to have to take it and see if you're going to react to it.
• 38:20
  So, but spending that much time and I'll have people who will come in and not do anything because they're worried.
• 38:26
  So a lot of times I think people tend to get stuck because of rumination, because of memory of unpleasant things.
• 38:35
  You have to learn to grow through that.
• 38:39
  And growing up, is probably what we're all struggling with.
• 38:44
  I mean, I have other things that I'm crazy about, but we all need to grow up.
• 38:47
  We cannot hold on to our backstory because it doesn't allow us to move forward.
• 38:54
  So stress and anxiety, find someone who does cognitive behavioral therapy or dialectical behavioral therapy or do one on your own.
• 39:02
  can do that a lot of free tools online, but overcome stress.
• 39:07
  And when you're stressed, It's your problem, not someone else's problem.
• 39:11
  Don't tell someone, I get very stressed about these things.
• 39:14
  That's why you need to do this.
• 39:15
  It's always, I get stressed over things.
• 39:18
  So I do the things this way so I can actually show up and do my job.
• 39:24
  Yeah, and I just had somebody on who talked extensively about breath work as a good way to solve this.
• 39:33
  you know, I think what you said really is true.
• 39:37
  It's not what's happening to us.
• 39:40
  It's our reaction.
• 39:42
  It's, you know, I love that saying that I've said this before, the suffering doesn't come from what's happening.
• 39:47
  It comes from not accepting.
• 39:49
  It comes from holding on to things and Yeah, mean, we have to find a way to let go.
• 39:57
  So speaking of, I kind of really want to go back to the gut and the immune system, but I also want to talk about stress and anxiety.
• 40:07
  And I know that you believe or that you know that stress and anxiety are also related to the gut.
• 40:14
  Is that right?
• 40:15
  Yes, that is for true.
• 40:16
  So when the I always think of it this way.
• 40:20
  I mean, this is my simplified version of explaining things to people.
• 40:24
  You have your whole body comes from an egg and a sperm.
• 40:28
  That's two cells.
• 40:29
  They combine.
• 40:30
  They give a lot of information to each other.
• 40:33
  And then the whole uh sheet of cells get formed and each cell gets a signal to, hey, you guys are going to become the brain.
• 40:41
  You're going to become the liver.
• 40:42
  How come we don't have a brain in the liver?
• 40:44
  Because the signal is there.
• 40:47
  But the cells that become the brain, a few of them go inward and become the lining of the gut and a few of them go outward and become the lining of the skin.
• 40:57
  So the trifecta, the gut-skin-brain connection is something that we see as a lifelong uh connection.
• 41:07
  Okay, I want to stop because this I really haven't heard this before.
• 41:10
  So when we're forming as a baby in and as an embryo are some of our brain cells go to our gut and some go to our skin.
• 41:20
  Yes.
• 41:20
  And that's why there is that connection.
• 41:23
  There's that connection.
• 41:24
  is nervous system connection.
• 41:27
  There are a few other things, but yes, these cells have memory and they tend to, for instance, the gut is connected to the brain by the longest nerve in the body called the vagal nerve, the wandering nerve.
• 41:41
  It connects the, but it doesn't touch the gut.
• 41:44
  It's outside and there's a chemical biochemical connection.
• 41:48
  And it's the only nerve that takes signal back to the brain rather than the brain telling, the gut what to do, it takes signal back to the brain.
• 41:57
  Whenever there is disarray in the gut, like your gut microbiome has shifted because you're stressed or because you had an antibiotic or you eat food that doesn't have any fiber, then there's chaos in the gut lumen.
• 42:12
  So basically the sheet of cells rolls over, the gut is essentially outside of your body.
• 42:17
  It got rolled over and became the pipe that lines goes from your mouth to the anus.
• 42:23
  So whatever's in your gut is not supposed to get into your body directly.
• 42:29
  The gut lining protects you.
• 42:31
  The gut lining has several layers.
• 42:34
  So the cells that line the gut, they're supposed to be very tight.
• 42:41
  They don't let, like you eat tomato, tomato doesn't float in your blood.
• 42:45
  It's only the nutrient from the tomato that goes into the blood.
• 42:49
  So that's because these cells are very tight.
• 42:52
  then the gut bacteria, your digestive enzymes break down the food to the nutrients and only the nutrients get absorbed then sent to your blood for processing.
• 43:05
  When you have chaos in your gut and the cells are getting kind of damaged by medications like For instance, when you take Motrin or when you take Ibuprofen or antibiotic, there's a certain amount of damage that happens because it's killing bacteria, there's death and dying and inflammation.
• 43:29
  These cells that are so tight will begin to loosen and get inflamed and nowadays begin to send stuff inside.
• 43:36
  So you get sensitive to gluten, to egg, to milk, to some vegetables.
• 43:42
  Almost, yes.
• 43:42
  That's called the intestinal permeability, but there's also bacteria that's leaking into your blood, which we measure as what is called LPS or lipopolysaccharides.
• 43:53
  Now the immune system is saying, my God, all these things, I've never seen them before.
• 43:57
  And it starts fighting to protect you.
• 44:00
  But a lot of our foods, keep in mind our foods are protein.
• 44:04
  They have very similar structure to our own cells.
• 44:07
  The immune system is so chaotic, it gets confused and Many a time it will attack you, your joints or your thyroid and you slowly develop an autoimmune condition or you develop a chronic form of inflammation, maybe even arthritis.
• 44:25
  And many a time people will just, what do they do?
• 44:28
  They eliminate certain foods.
• 44:29
  They'll say, I can't eat nightshades.
• 44:33
  My joints swell.
• 44:34
  They don't think of it as why am I not able to eat nightshades?
• 44:38
  I used to be able to eat it as a child.
• 44:39
  Why am I not able to eat it now?
• 44:41
  You never ask that question.
• 44:43
  So if you ask that question, you actually can go to the gut, heal the gut lining.
• 44:48
  There's a way to do that.
• 44:48
  That's something what most functional medical doctors are trained to do.
• 44:53
  And get to a point where you can get back to effortless nourishment.
• 45:00
  When you restrict your food, you're putting so much effort to plan, to avoid, to...
• 45:05
  I mean, obviously we don't want you to eat processed food, but we want you to be able to eat all vegetables, all kinds of...
• 45:11
  whatever protein you want to eat, all kinds of grains without having to struggle.
• 45:17
  Of course, if you have a genetic trait like the celiac gene, if you do have it, then you want to avoid it.
• 45:22
  But otherwise, most people should be able to tolerate regular food and once in a while eat entertaining food.
• 45:28
  You want to have a pizza one day?
• 45:30
  You should be able to have it without having to struggle about bloating or reaction to the food.
• 45:37
  So I think the point I'm trying to make is Yes, the gut is being healthy is going to make the biggest difference in your health.
• 45:48
  Whether it's.
• 45:50
  And is that just, how do you make your gut healthy?
• 45:54
  that eating a lot of fiber?
• 45:57
  It depends on what destroys your gut.
• 45:59
  So some people could be very, very healthy and they would go out, travel to Mexico, come back with acute gastroenteritis.
• 46:06
  The whole gut bacteria changes.
• 46:08
  So you have to take every gut issue as serious.
• 46:12
  When you are struggling with gut issues, you should solve them, figure out why you have them and solve them rather than live a restrictive life or take tums.
• 46:23
  I can't eat spicy food.
• 46:25
  I can drink caffeine.
• 46:26
  I get heartburn.
• 46:27
  I hear people tell me these things all the time and I'm always asking them, instead of living a restrictive life, is there a way we could expand your ability to eat these foods and for that have a robust gut?
• 46:42
  I may not be able to make your gut as robust as a 20 year old.
• 46:45
  Have you seen 20 year olds or even 16 year olds that can eat a whole pizza and go for a bowl of pasta with marinara sauce and still in two hours eat again another big meal.
• 46:56
  As you get older, that doesn't happen, right?
• 46:58
  And you just need to heal the lining of the gut once that happens.
• 47:04
  But on a regular basis, people who never have gut problems, what they eat mostly, they chew their food.
• 47:10
  That's the number one.
• 47:12
  You got to chew your food because you got to stimulate the enzymes.
• 47:15
  Number two, they have solid acid production in the stomach.
• 47:18
  Acid production gets disrupted with stress.
• 47:21
  So they have good enzymes.
• 47:23
  Number three, they do have good gut bacteria.
• 47:26
  Eating whole foods mostly and the most important fasting, which is giving time.
• 47:32
  If you're eating every two hours and eating all the way from bed from the time you rise up right up to bedtime, you're staying in an inflamed state because when you eat food, your gut is inflamed for two to four hours after a meal.
• 47:46
  So imagine if you're eating every two hours, you're chronically inflamed.
• 47:51
  So the timing of your meals, the quality of your meals, and the rest time you give to your gut will all determine your gut health.
• 48:01
  And yes, the gut microbiome does love fiber.
• 48:04
  So ideally most people should eat enough fiber.
• 48:08
  Though I would say the things that really I don't have a good sense of, I don't think the scientific world has still been able to explain how do carnivores, people who eat just a meat and no fiber still do well.
• 48:23
  and many of them have rivers, their diabetes and their skin conditions.
• 48:27
  This lot we don't know, but these are the people who can never eat in a plant again because they get bloated, they'll get all their inflammation back because their gut leakiness never got fixed.
• 48:36
  It just removed something that triggers the leakiness and that's why they feel better.
• 48:42
  So in many ways, we know short chain fatty acids is an essential food and particularly butyrate.
• 48:51
  giving, making sure you can, your gut microbiome can produce enough butyrate, which we can test for.
• 48:58
  It's probably the number one thing that we look.
• 49:00
  Number two is making sure you don't have a leaky gut and you don't have inflammation.
• 49:04
  We look at your immunoglobulin in the gut.
• 49:06
  We look at markers of inflammation like zonulin.
• 49:10
  And then we look at any inflammatory like calc protectin, IgA, those are the things that we look at.
• 49:16
  And we look at the...
• 49:17
  composition of your gut bacteria.
• 49:19
  Do you have a good balance of good and bad bacteria?
• 49:24
  What we call a normal bacteria, commensal bacteria, these are the normal bacteria you should have.
• 49:29
  And what we call as pathogenic bacteria, they are there, but in small amounts, they have a specific job that they should not overgrow.
• 49:36
  So we can look at all of that.
• 49:38
  In general, to keep a good gut health, make sure you chew your food, you eat whole foods mostly, have enough fiber.
• 49:48
  And can you explain the connection?
• 49:52
  Or is that the connection?
• 49:53
  Because we get anxiety or depression because of our gut is often it's connected to our brain.
• 50:00
  that why?
• 50:01
  actually, what they've noticed is when there is inflammation in the gut, uh there's also, remember the nerve cells that find their way into the gut during development, these cells produce hormones called serotonin, which is your happy hormone.
• 50:16
  They've not been able to show a definite connection between serotonin and your happy, from the gut and the happiness in your well-being, but they do find it gets disrupted.
• 50:29
  When your gut microbiome is disrupted, there's inflammation in the gut, there's inflammation in the blood, and that inflammation is in the brain.
• 50:39
  So inflammation in the gut, and what is inflammation?
• 50:42
  When you have a cut, you have the redness, swelling, and pain.
• 50:45
  Imagine having like a thousand paper cuts in your gut in varying stages of healing.
• 50:51
  When you're that inflamed and there's a lot of the substances leaking into your blood, your brain gets inflamed.
• 50:58
  We see this all the time in functional medicine.
• 51:00
  When we treat the gut, people have regular bowel movements, easy to pass, clean to wipe.
• 51:05
  They don't have any bloating sensation.
• 51:07
  um They don't feel scared to eat.
• 51:11
  It's not like they go out to eat and they have to look out for the bathroom because they're going to have the runs.
• 51:15
  If none of that is there, they usually, their mood is very good.
• 51:19
  But 100 % when you have depression and anxiety, your gut acts up.
• 51:24
  or your gut acts up and therefore you have depression and anxiety.
• 51:27
  don't know the connection, but I don't know which the egg and the chicken, but they are all co-exist.
• 51:34
  Wow.
• 51:35
  And is there also usually a skin connection like eczema or psoriasis?
• 51:42
  eczema, psoriasis, dermatitis, acne, all of them.
• 51:47
  Getting your gut healthy will get your skin healthy.
• 51:50
  You see that all the time.
• 51:51
  And sometimes it's connected to the nutrition.
• 51:53
  Sometimes it's connected to your lack of enzymes.
• 51:56
  Sometimes it's just connected to stress.
• 51:58
  So, and you know, you would think the gut being such a high traffic area, because everything that gets into your body should get to the gut, should be a robust place.
• 52:08
  It is.
• 52:09
  It's supposed to renew itself, but I think the level of abuse we put it through, it's having a tough time trying to heal.
• 52:17
  And so I think it's so important.
• 52:19
  always tell people when you get, when you're struggling with a gut tissue, like you're having diarrhea, gastrointestinal dis, the best way to heal your gut is stop eating.
• 52:27
  Just completely cut eating for 24 hours.
• 52:29
  You will be so much better.
• 52:32
  What do people do?
• 52:33
  Oh, she's having nausea, vomiting, diarrhea.
• 52:35
  I'm trying to give her some chicken and chicken soup.
• 52:37
  Stop doing that.
• 52:38
  The body is eliminating it.
• 52:40
  Give it time to rest.
• 52:41
  And trust me, you'll be fine in 24 hours.
• 52:45
  So the gut needs space to heal.
• 52:47
  It needs the right kind of nutrition to heal.
• 52:50
  It needs the right kind of workers in the gut, the microbiome to be healthy.
• 52:56
  So it's a combination of everything.
• 52:58
  And this is where I think gut health is something If you're far gone, it's better to get professional help rather than just buy probiotics online and try to fix your gut.
• 53:10
  Okay.
• 53:11
  And, I was going to ask you something else now.
• 53:13
  can't remember.
• 53:14
  Stress, anxiety, oh, immune system too.
• 53:18
  So that's your, also, once you get your gut straight, it's going to improve your immune system as well.
• 53:24
  Exactly.
• 53:25
  Yes, your immune system should not be so triggered.
• 53:28
  It's supposed to fight bacteria and viruses outside of the body.
• 53:32
  When it's fighting you and causing autoimmunity, there's a little chaos and cross signals there.
• 53:40
  So getting your gut healthy becomes so important so that the cross signals and the immune system knows exactly what is self and what is something outside of the gut.
• 53:52
  So yes.
• 53:53
  you will have a very good immune system if you have good gut health.
• 53:59
  And I just want to say, I hope it's okay for me to say this because you keep talking about like meat and these things.
• 54:06
  I know that you personally eat a whole food plant-based diet, right?
• 54:10
  Yes.
• 54:10
  Okay.
• 54:11
  I just want to throw that out there so people don't think I've gone crazy trained and bringing in somebody who is em advocating for the carnivore diet or anything like that.
• 54:23
  But I think that you also are saying that You do a lot of testing through your practice and some people can tolerate that, know, meat or whatever better than others.
• 54:35
  Yeah, yeah, I find this when people intuitively become plant based.
• 54:40
  I almost can bet when I look at their genetics, they have a lot of difficulty processing fats.
• 54:46
  just genetic.
• 54:47
  There are some enzymes.
• 54:48
  Yeah, there are some enzymes that don't work well in their body and they don't feel better.
• 54:52
  They will have high cholesterol.
• 54:54
  They will have heart disease.
• 54:57
  Yeah, so I'm a big fan of fiber.
• 55:00
  I'm a big fan of plant based, but I also you know, as I mentioned to you even before we started this conversation is I don't advocate 100 % plant based for everyone because you have to make it practical.
• 55:16
  The food that you're going to be eating and that's going to work for you is the food that you're going to eat on a regular basis.
• 55:21
  If I make it impossible for you, you're not going to get better.
• 55:24
  You can't force people to change food, nutrition and food.
• 55:28
  I've learned it's like religion.
• 55:31
  You don't change your religion unless you believe in something.
• 55:34
  You can't force people to change religion.
• 55:36
  You can't bribe them to change religion.
• 55:38
  You could probably, but it's because what they have doesn't work well for them and so they are switching over to, or they have a belief system.
• 55:48
  So yes, when patients come to me, I don't talk about a whole food plant based with everyone, but I do advocate a high plant forward diet for most people because that is undisputed.
• 56:02
  You can argue high and low with me about carnivore and keto.
• 56:06
  I see patients.
• 56:08
  I can tell you almost 98 % of the time, most people cannot serve, will not thrive socially or, health wise on those diets.
• 56:19
  don't long-term short-term, it always works because it's like you're eliminating processed foods, but long-term it's almost impossible.
• 56:31
  So It's the thing, you you can't, where is a vegan diet or plant-based diet?
• 56:35
  You can, unless you're traveling in middle America where you cannot find a single place other than Chipotle that will give you something that's plant-based.
• 56:43
  I'm just saying it's just not, it's very difficult.
• 56:45
  You have to pack your food when you're traveling.
• 56:47
  Yes.
• 56:49
  It's difficult and I pack my food.
• 56:50
  I'm always pulling things out of my, yes, I will concede it's not always easy.
• 56:55
  But okay.
• 56:56
  Okay.
• 56:56
  So I just wanted to throw that out there.
• 56:58
  um And then, you know, lastly, I really want to talk about the peri-metapause, metapause thing because it's really having a moment, right?
• 57:08
  Yes.
• 57:09
  mean, okay.
• 57:10
  So can you talk about that a little bit and how we can thrive during that?
• 57:15
  Absolutely.
• 57:16
  I think I looked up a card recently.
• 57:18
  says, you're hot, except that it comes in flashes.
• 57:24
  I would say for almost a decade, I remember I started practicing medicine in the United States in 1996.
• 57:35
  So around that time, till about 2000, maybe 2001, 2002, Hormone replacement therapy was something that we did naturally because we said it's good for your bones, it's good for your brain at that time.
• 57:48
  And then the women's initiative came about and overnight I was withdrawing estrogen, progesterone from all my patients, telling them they might die of a heart attack.
• 58:01
  I was too young, I didn't read the study.
• 58:05
  I did what I was told.
• 58:07
  That's what everybody did.
• 58:08
  But today and in the last few years, I would say even before it became a sensation and Hollywood was promoting it, we've been doing hormone replacement therapy because not all women need hormone replacement therapy.
• 58:25
  Let me put it out there.
• 58:26
  Some women can sail through perimenopause and menopause almost like you asked them.
• 58:31
  I don't even know when my last menstrual period was.
• 58:33
  That's what they will say.
• 58:34
  Others will begin to see that they nature there, they become anxious, they become depressed, they become difficult.
• 58:41
  Their kids say that they are very difficult.
• 58:44
  Their husband, the spouse finds them um again, no longer attractive, not because of their physical changes, just because how they behave.
• 58:54
  There's something about your brain that begins to change as your estrogen begins to fluctuate.
• 59:01
  So I've done We do hormone testing in our practice.
• 59:05
  I've had patients who've had estrogen as high as 1200 and as low as 15 and they will go up normally 350 at your peak of ovulation and they go all the way high and they go all the way down and this is in your, your brain, there's a certain area of your brain that depends on the hormones.
• 59:27
  There is chaos when these hormones are fluctuating.
• 59:31
  Progesterone, like I said earlier, is a natural antidepressant anti-anxiety.
• 59:37
  in some, small percentage, almost 30, 35 % of women, when their hormones get withdrawn, they go crazy.
• 59:46
  They get bat shit crazy.
• 59:47
  I'm sorry if I.
• 59:48
  No, you can say whatever you want.
• 59:50
  You can say bad shit for sure.
• 59:51
  You can say whatever the hell they go they go so nuts.
• 59:55
  They realize it and many of them go to their doctor and say, I could be in perimenopause first of all in conventional medicine, they recommend not testing hormones.
• 1:00:04
  Number two, they say, well, if you have your periods, you don't need any hormone replacement, which is not necessarily right.
• 1:00:13
  If the woman has symptoms.
• 1:00:16
  She definitely needs to be treated.
• 1:00:18
  And the best treatment they get is an antidepressant, which is also a treatment for perimenopause.
• 1:00:23
  But many a time, I find that giving them a little hormone, some stability for that fluctuation makes them feel so much better.
• 1:00:32
  I can tell you the number of my patients that come back and feel completely different.
• 1:00:37
  It's not going to transform you and make you 20.
• 1:00:39
  That's not what it's doing.
• 1:00:40
  But it helps your brain calm down from the withdrawal.
• 1:00:46
  and you're giving some degree of stability.
• 1:00:49
  But does that mean everybody who's 35 come in for hormone replacement?
• 1:00:54
  No.
• 1:00:54
  I mean, we are all now experiencing FOMO.
• 1:00:57
  So I want to be very clear about this.
• 1:00:59
  Once again, know your symptoms, test yourself, rather than just jumping around and saying, need hormone replacement.
• 1:01:08
  I can't tell you the number of people who asked me for crazy tests about hormone.
• 1:01:11
  There's a test where you can.
• 1:01:14
  Check the metabolites of estrogen.
• 1:01:16
  You don't do that till you check the blood level So don't go buying tests and buying supplements for your balancing your hormones.
• 1:01:24
  There's nothing wrong with your hormones, by the way your body There's no I don't think there's physiologically something called balancing of hormones Your body responds to your trigger.
• 1:01:37
  Who are the people I've tried to do this research Who are the people who struggle with the transition?
• 1:01:42
  Usually people who are highly stressed, have not been taking care of themselves, who don't exercise, who drink alcohol or smoke.
• 1:01:53
  Very clear.
• 1:01:55
  then they're going to struggle maybe more.
• 1:01:56
  Because I'm starting to go through menopause.
• 1:01:59
  I'm old.
• 1:02:00
  I just turned 57 and I'm just starting to miss my period or whatever.
• 1:02:06
  You're lucky! You're so lucky! That means you've had your estrogen for so long! I've had it for a long time, but honestly, uh I haven't had any problems, knock wood.
• 1:02:17
  But I'm also not a very stressed person, thank God.
• 1:02:20
  I live a very fortuitous life um and if I do have stress, I try to manage it and I eat the whole food plant-based diet and all the things.
• 1:02:35
  And so I do wonder if there's that correlation.
• 1:02:40
  Unfortunately, no one's done a study, right?
• 1:02:42
  They haven't taken women who are robust, are healthy, who eat balanced meals, who know how to manage their stress, who don't drink alcohol every day, who don't smoke and compare them to regular women who live a very stressed life.
• 1:02:58
  mean, majority of us do.
• 1:03:01
  And see, is there anything that the lifestyle does?
• 1:03:04
  Nobody's ever going to do that study.
• 1:03:06
  But I will say, I see that in my practice, right?
• 1:03:08
  m I have so many who are like you in their mid fifties come and say, I don't know all my friends are at home and replace me and I feel fine, but do you think I should go on it?
• 1:03:18
  I'm like, I don't know if you have no symptoms, if you should, but we, know, I do the bone density.
• 1:03:23
  look at their brain health and then determine if there might be a slight advantage of giving them some estrogen.
• 1:03:31
  It should, I don't have clear, I wouldn't say I have clear.
• 1:03:35
  guidelines, it's 100 % sure everybody needs to be on estrogen and progesterone.
• 1:03:40
  I don't know that for a fact, but anybody who's symptomatic, who's struggling with a change in their mood, who is at a high risk for osteoporosis, high risk for cardiovascular or dementia, I think it's worthwhile giving that a try.
• 1:03:54
  Yes.
• 1:03:55
  And do you, um I have had somebody on before an OB-GYN who said that she really feels like only vaginal estrogen is safe.
• 1:04:06
  Is that how you feel or?
• 1:04:09
  Okay.
• 1:04:10
  What do you, what, do you say?
• 1:04:12
  We do vaginal estrogen if you have vaginal symptoms, but we do give, so what the studies show is there are two hormones that come from your brain, a luteinizing hormone and follicular stimulating hormone, they are called LH and FSH.
• 1:04:30
  They start going high as your ovaries begin to fail.
• 1:04:34
  When the FSH is over 100 and your estrogen is low, FSH kind of double duties and it will collect fat, you start gaining weight and it will also accumulate liver fat.
• 1:04:49
  You'll get a fatty liver.
• 1:04:51
  Again, it may be correlating with how you eat and what you eat.
• 1:04:57
  However, if you give estrogen replacement and bring down the FSH down to less than 70, you tend to have less accumulation of fat.
• 1:05:06
  Nobody wants to be obese.
• 1:05:08
  A lot of women who are all their life they've been thin, suddenly begin to see the midsection fat accumulating, right?
• 1:05:15
  Because that is coming from the FSH.
• 1:05:17
  So hormone replacement does help you keep your body composition less visceral fat uh and less subcutaneous fat, better bone density, better brain health, especially if you have a specific gene called APOE4.
• 1:05:33
  And in many ways- Is that the Alzheimer gene?
• 1:05:37
  Yes.
• 1:05:37
  Yes.
• 1:05:38
  So there are circumstances where systemic estrogen and progesterone are, and they are deemed safe.
• 1:05:46
  That's where the Women's Health Initiative completely botched the whole thing for a whole decade of women saying that it increases cancer.
• 1:05:56
  There is a small 2 to 4 % increased risk of cancer.
• 1:06:01
  But again, now we can do genetics.
• 1:06:03
  We can see how your estrogen is metabolized.
• 1:06:05
  We can minimize those.
• 1:06:07
  So there are different ways to do that.
• 1:06:10
  To me, I hormone replacement or menopausal hormone treatment is absolutely safe.
• 1:06:16
  As of today, with the knowledge I have today.
• 1:06:18
  Now, Tanya, five years from now, I might sing a different tune.
• 1:06:21
  Sure, sure.
• 1:06:22
  And you're saying that it can be delivered in different things besides vaginally, what, orally?
• 1:06:28
  Absolutely.
• 1:06:30
  I'm normally we use the patch.
• 1:06:33
  There's an oral that is FDA approved.
• 1:06:35
  The patch is FDA approved.
• 1:06:37
  I don't use compounding.
• 1:06:39
  um I don't I don't see any study that shows compounding is better.
• 1:06:43
  um There's a Trosh that you can use.
• 1:06:48
  I personally don't like that.
• 1:06:52
  Okay, yes.
• 1:06:53
  And I would say the uh oral one that you do also is like the oral contraceptive.
• 1:07:01
  We've been taking oral estrogen forever as a female species.
• 1:07:05
  So I don't think it's necessarily dangerous, but there's always this, it has to bypass through the liver and some people don't break it down.
• 1:07:14
  I find the patch to be the most, what can I say, tolerated, well tolerated.
• 1:07:22
  And I see a sustainable response to it.
• 1:07:26
  And I'm targeting a specific level for bone density or a specific uh result like removing the hot flashes, calming the brain down.
• 1:07:39
  Those are the things that I'm looking forward to when I'm giving a hormone replacement.
• 1:07:44
  Yeah, I mean, people need some relief.
• 1:07:48
  Yes, it's results oriented.
• 1:07:50
  everything about hormone replacement is result oriented.
• 1:07:54
  And the question is whether you need it, does every woman need it?
• 1:07:57
  I don't have the answer for it.
• 1:08:00
  I do it on an individual basis, depending on like if somebody needs it, absolutely, but they're afraid of hormone replacement.
• 1:08:07
  I don't try and convince them to take hormone.
• 1:08:10
  I'll give them all the education.
• 1:08:12
  But I like it like the OBGYN, you may have had on your podcast who thinks that it is dangerous.
• 1:08:18
  A lot of women think it's dangerous, but I don't see the data that shows it's dangerous.
• 1:08:23
  There is no data that shows it's dangerous.
• 1:08:27
  Okay.
• 1:08:29
  And anything else you want to say about hormones or menopause?
• 1:08:33
  Once again, get tested.
• 1:08:34
  Please get tested.
• 1:08:35
  Please.
• 1:08:36
  What kind of should they be asking for?
• 1:08:39
  Ideally, go to a hormone special, somebody who's trained in hormones.
• 1:08:46
  Not every Ob-Gen, unfortunately, knows how to give hormone replacement.
• 1:08:50
  They're not trained in menopausal hormone treatment.
• 1:08:52
  So there are urologists, there are endocrinologists, there are internists, there are family practice.
• 1:08:59
  If they're trained in menopausal hormone treatment, they would be the ideal.
• 1:09:04
  Let them determine what kind of test, but ideally the blood test is the golden standard for now.
• 1:09:09
  There are several, there's salivary tests, there's urine tests, and each specialist has a, each of these tests have their pros and cons.
• 1:09:18
  I use them differently for each patient.
• 1:09:21
  So I would say the biggest challenge in medicine today and the biggest asset in medicine is the availability of information.
• 1:09:31
  So it's great your patients come in informed, they have AI tools, they've educated themselves.
• 1:09:36
  I love it.
• 1:09:38
  but it is also a deterrent to help them do what they should be doing.
• 1:09:44
  Because me as the doctor, I'm looking at your tests, your history, the guy who sold this online is just selling his product.
• 1:09:52
  So, his or her product.
• 1:09:53
  So they want to do all these tests that they heard of in a podcast or they want to do, take the supplement they heard of in a podcast.
• 1:10:00
  And I'm not even sure how it's going to work or pan out for you.
• 1:10:04
  Right?
• 1:10:05
  So I feel You should seek personalized medicine when it comes to hormone replacement.
• 1:10:11
  And your hormones do not go out of balance.
• 1:10:14
  Your environment does and your hormones are trying to adapt to your imbalanced environment.
• 1:10:20
  So you got to learn to fix your environment first before you start fighting your own body.
• 1:10:25
  Yeah, I agree with that.
• 1:10:28
  so, you know, I think that goes back to what you were saying, what you're eating, how much you're exercising, how you're managing your stress and your sleep.
• 1:10:39
  Yes, yes, absolutely.
• 1:10:42
  You do that 90 % of the time well.
• 1:10:45
  Unlikely, you'll have a lot of problems.
• 1:10:49
  Okay, sounds easy, but I know it's not for everybody.
• 1:10:53
  um Okay, well, what's your best piece of advice for aging well?
• 1:10:58
  For aging well, would just say, first of all, accept aging.
• 1:11:04
  You're going to get older.
• 1:11:05
  I think that's the most important thing.
• 1:11:07
  old are you?
• 1:11:08
  I'm 59.
• 1:11:10
  59, you are, mwah, mwah, chef's kiss.
• 1:11:15
  You're doing it, you're doing it.
• 1:11:17
  Okay.
• 1:11:18
  ah Yeah, this is first time I decided I was not going to color my hair and I'm going to do another one.
• 1:11:23
  Yes, yes.
• 1:11:24
  It's beautiful.
• 1:11:25
  Trying to get used to that look.
• 1:11:27
  But I will say, uh except that you're going to get old, but don't accept any um disease or dysfunction as a part of aging.
• 1:11:40
  Disease and dysfunction is something you have to look at, look into.
• 1:11:46
  And then Make sure your environment every day you wake up you're waking up with peace.
• 1:11:51
  I don't know if everybody can wake up with joy but wake up with peace.
• 1:11:56
  Be at peace with the decisions you've made and where you are.
• 1:12:00
  When you're constantly striving for something that doesn't exist or something that's in your past you're going to age much faster.
• 1:12:09
  That's been shown.
• 1:12:10
  People who struggle with chronic depression and anxiety do age much faster.
• 1:12:15
  So they have to fix their gut.
• 1:12:21
  Okay.
• 1:12:22
  And um what, do you have a favorite health or beauty product?
• 1:12:28
  my God.
• 1:12:28
  You know what?
• 1:12:29
  I tend to use very natural products because again, it's my upbringing.
• 1:12:35
  I don't like perfumes, I use, I get oil at the Sandalwood oil from India and I use that as my perfume.
• 1:12:47
  My moisturize.
• 1:12:49
  No, I just put it on here.
• 1:12:50
  It's very, no, I just take a drop.
• 1:12:54
  It's so expensive.
• 1:12:55
  guess.
• 1:12:56
  Sandalwood oil from India?
• 1:12:58
  Yes, I actually go to their cottage industry by Sandalwood every time I go every year I go I buy a few I give a few to my friends, but I hold on to a good amount of it for the whole year.
• 1:13:10
  I do jasmine oil.
• 1:13:12
  So I use for perfume I use oils for my skin moisturizing I use oils I use a lot of coconut and sesame oil.
• 1:13:19
  I rarely use chemical products.
• 1:13:23
  But of late I have compounded a product with ester.
• 1:13:27
  Estriol, which is an estrogen cream for my face, which I get from the pharmacy, but I it's actually compounded by the pharmacist with uh hyaluronic acid to just allow I mean, as you get older, especially Indian women tend to have uh pigmentation on their face.
• 1:13:45
  And I'm trying to avoid pigment because I look at my relatives and see, you know, the darkening the insulin resistance that shows up and all of those.
• 1:13:53
  So I try to maintain using a compounded cream.
• 1:13:58
  So that might be the only chemical that I Somebody was just talking about that.
• 1:14:02
  I haven't released her podcast.
• 1:14:03
  Maybe by the time I released hers, but she also said that.
• 1:14:06
  So, if you're getting something compounded by the pharmacist, that means you have to have a prescription from the doctor.
• 1:14:12
  Yes.
• 1:14:12
  Yeah, you have to go to the doctor and ask them to write a prescription for a compounded uh face cream with estradiol.
• 1:14:22
  It's not estradiol, estradiol.
• 1:14:24
  Estriol.
• 1:14:25
  Yeah.
• 1:14:25
  And hyaluronic acid.
• 1:14:28
  I can't remember when I wrote it down, you we had discussed and she had given it.
• 1:14:36
  So I would say there are that's the only chemical product that I use.
• 1:14:40
  most of the other stuff is pretty much as natural as they come in their whole form.
• 1:14:46
  ah That sounds good.
• 1:14:48
  And do you have a favorite concert you've ever been to?
• 1:14:51
  my God, concert.
• 1:14:53
  Most of mine are uh Indian artists.
• 1:14:57
  I go to A.R.
• 1:14:58
  Rahman or Eli Raja.
• 1:15:00
  are my like the Southern artists.
• 1:15:02
  There are a lot of, I love, uh the only concert I've been to uh was Taylor Swift's.
• 1:15:12
  That's good one.
• 1:15:15
  It was really fun.
• 1:15:16
  loved it.
• 1:15:17
  was so much fun.
• 1:15:19
  Yes, she's a real good entertainer, but otherwise I'm not a concert person because you can enjoy each other.
• 1:15:26
  You can only enjoy the concert.
• 1:15:28
  The noise is so much.
• 1:15:30
  I don't enjoy that so much.
• 1:15:33
  Not everybody loves a concert, but Taylor Swift's a good one for you to be.
• 1:15:38
  Yeah.
• 1:15:39
  And do you have a favorite public person that you admire for how they're aging?
• 1:15:44
  How they are aging, my God, yes.
• 1:15:47
  ah I actually look at, you'll be shocked if I say that, it's somebody who doesn't follow any of the rules.
• 1:15:55
  I really love the way Warren Buffett ages.
• 1:15:59
  Warren Buffett?
• 1:16:01
  would say him.
• 1:16:03
  I love him, but I would never say because of how he ages just because I guess yeah, he lives.
• 1:16:08
  I mean, he's lived a full life and he still gives talks and he still advises.
• 1:16:14
  The thing about him is he's broken all the rules, right?
• 1:16:19
  He has never had a vegetable.
• 1:16:21
  He eats candy.
• 1:16:22
  He drinks Coke.
• 1:16:24
  What I like about him, the only reason, yes, the only reason I think he's aging well is because he's always in a parasympathetic state.
• 1:16:32
  Yes, he's a peaceful person.
• 1:16:35
  That's why I think that's what I admire about it.
• 1:16:37
  I'm not admiring him like it does he look young?
• 1:16:40
  Does he look fit?
• 1:16:41
  No, none of that.
• 1:16:42
  But it is almost like his mind is so sharp.
• 1:16:46
  Of course, he stepped down very recently and what is in his mid 90s.
• 1:16:51
  um Yeah, in the mid 90s, if I'm not mistaken.
• 1:16:57
  He's a I thought he was uh five years younger than Charlie Mung.
• 1:17:01
  Maybe I'm wrong, but I'm just saying I.
• 1:17:04
  find that the love for life and the really the parasympathetic state he lives in is what is anti-aging for me.
• 1:17:18
  my gosh, I would have never thought about him.
• 1:17:21
  But now that you're saying that, I remember hearing a long time ago that he um gave his family just enough money for whatever.
• 1:17:31
  He paid for everybody's college, but then he didn't give them like a bunch.
• 1:17:35
  He didn't really give anybody money because he wanted all his grandchildren and his children to go out and seek their own lives and not live off of him.
• 1:17:44
  I thought that was really admirable.
• 1:17:47
  I love that.
• 1:17:48
  Yeah.
• 1:17:48
  mean, otherwise you find many wealthy people, the next generation just brings it down because they don't understand the value of work, right?
• 1:17:57
  The ethics.
• 1:17:58
  So yes, he's got all of those.
• 1:18:00
  He's got some crazy ideas, but I think in general, he's in a parasympathetic state.
• 1:18:05
  And for people to age gracefully, you got to find your parasympathetic self.
• 1:18:10
  Yeah.
• 1:18:11
  m Okay, we're going to end on that.
• 1:18:14
  Dr.
• 1:18:15
  Chelham, you are full of good information.
• 1:18:17
  I appreciate you being here and sharing with us.
• 1:18:20
  Thank you.
• 1:18:20
  Thank you so much Lauren for this opportunity.
• 1:18:23
  care, bye.
• 1:18:24
  Thanks for listening, friend.
• 1:18:26
  From my heart to yours, be well until we meet again.